Comment by Bernard Carroll

I thought the Luhrmann piece was just pretentious pabulum and from an anthropologist, yet! Your reference to NIMH concerns RDoC - a contrived matrix of metaphysical constructs developed by armchair bound, top-down bureaucrats with too much time on their hands - I'm talking about Insel and his lieutenant Cuthbert. Dr. Insel doesn’t seem to understand the need to advance nosology by incorporating biomarkers along with clinical symptoms in diagnostic definitions, as happened in general medicine. Consider where we would end up if, for instance, we lumped Cushing disease together with juvenile onset diabetes mellitus, Type II diabetes mellitus, severe psychological or physiological stress, metabolic syndrome, anorexia nervosa, and pregnancy on the basis of an abnormal glucose tolerance test, which these all can display. We can expect that eventually the RDoC matrix that Dr. Insel insists should be adopted in new grant proposals will go the way of the eccentrics and epicycles of 16th Century astronomy. The pressing issue is how much damage will be done before that happens?